In a large representative sample of opioid-naive, cancer-free adults who received a first prescription for opioid pain relievers, the likelihood of long-term opioid use increased with each additional day of medication supplied, starting with the third day, the study team found.
"Knowledge that the risks for chronic opioid use increase with each additional day supplied might help clinicians evaluate their initial opioid prescribing decisions and potentially reduce the risk for long-term opioid use," the authors, led by Bradley Martin, PharmD, PhD, at the University of Arkansas for Medical Sciences in Little Rock, write.
The highest probability of continued opioid use at 1 and 3 years was in patients who were initially prescribed a long-acting opioid (27.3% at 1 year and 20.5% at 3 years), followed by those who initially received tramadol (13.7% at 1 year and 6.8% at 3 years) or who received a Schedule II short-acting opioid other than hydrocodone or oxycodone (8.9% at 1 year and 5.3% at 3 years).
There were no differences in the probability of continued opioid use at 1 and 3 years for individuals who were initially prescribed short-acting hydrocodone (5.1% at 1 year and 2.4% at 3 years), short-acting oxycodone (4.7% at 1 year and 2.3% at 3 years), or a Schedule III-IV opioid (5.0% at 1 year and 2.2% at 3 years).
However, a recent report from the Substance Abuse and Mental Health Services Administration did show that emergency department visits associated with tramadol-related adverse events increased by 145% during 2005-2011.